February 22, 2013

How do we learn? What allows us to retain new information and
have it available in the future? Is learning driven by external stimuli in the
environment or is it dependent on internal processes within the learner? These
are the questions that drive theorists to explore the mysterious world of
educational psychology. Some of the
fundamental theories of learning include social learning, constructivism, and
behaviorism attempt to answer some of these questions. And new understandings are emerging all the
time. A relatively new concept called
“habits of mind” has been described and it’s taking the world of education by
storm.

First described by Arthur L. Costa, Ed.D and Bena Kallick, PhD,
habits of mind (HOM) are specific behaviors that intelligent humans employ when
confronted with problems in which the resolution is not immediately known.1
These 16 habits (defined in Table 1) attempt to explain how behavior and
learning are intertwined and dependent on one another. Costa and Kallick suggests
that each time these behaviors are employed, “the effects of their use are
reflected upon, evaluated, modified and carried forth to future applications.” This
ability is what they define as intelligence in humans, which is a distinct concept
from cognitive ability. The pair believes that intelligence is not just about
having information but knowing how to use the information to act in specific
situations based on previous experience. This concept applies to both academic
and non-academic situations.

Table 1

Habit of Mind

Description

Managing Impulsivity

Taking
the time to deliberate before acting.

Listening with Understanding and
Empathy

Making
the effort to perceive another person’s perspective.

Thinking Flexibly

Considering
Options and Changing Perspectives.

Striving for Accuracy

Setting
high standards and finding ways to improve.

Persisting

Persevering
in a task to completion and not giving up.

Metacognition

Thinking
about one’s thinking. Being aware of how thoughts, feelings and actions
affect others.

Questioning and Problem Posing

Findings
problems to solve, seeking data and answers.

Applying Past Knowledge to New
Situations

Accessing
prior knowledge and applying that knowledge to new contexts.

Thinking and Communicating with
Clarity and Precision

Striving
for accuracy in oral and written communications.

Gathering Data Through all
Senses

Paying
attention to the world around through taste, touch, smell, hearing and sight.

Creating, Imagining and
Innovating

Generating
new and novel ideas.

Responding with Wonderment and
Awe

Being
intrigued by the mystery in the world.

Taking Responsible Risks

Living
on the edge of one’s competence.

Finding Humor

Enjoying
the incongruous and unexpected. Being able to laugh at oneself.

Thinking Interdependently

Being
able to work and learn as a team.

Remaining Open to Continuous
Learning

Resisting
complacency in learning and admitting when one does not know.

Adapted from Campbell4

I find this to be a very intriguing concept of how intelligent
people utilize their knowledge. Prior to reading about HOM, I believed, as most
people do, that intelligence was driven by how much knowledge one has and the
ability of that person to retrieve that knowledge. This new concept suggests
that deeper processes are important. It’s
not simply a matter of storage and retrieval. While Costa and Kallick
introduced me to the HOM concept, it wasn’t until reading an excerpt from How Children Succeed: Grit, Curiosity, and the Hidden Power of
Character by Paul
Tough that I began to fully understand that this concept transcends the
classroom.2 In his book, Tough describes how one’s character is a
stronger predictor of life success than cognitive ability. He provides a number
of examples to illustrate this point, the most striking being “The Perry
Preschool Project”, a sociology experiment that began in the mid-1960s in an
industrial town west of Detroit. This study randomly assigned three- and
four-year old children into either an intervention or a control group. The
intervention group was enrolled in Perry Preschool, a two-year, high-quality
preschool program. The control group was not. The initial intent of the project
was to evaluate the effect of Perry Preschool on the children’s IQ – a measure
of intelligence. The initial results of this experiment showed that those that
attended Perry Preschool performed better on cognitive tests but the difference
between the groups diminished by the time they reached the third grade. Interestingly,
when evaluating the long terms results, those children that attended Perry
Preschool were more likely to be “successful” in life. They were more likely to
graduate from high school, to be employed at age twenty-seven, and to be
earning a higher salary at age forty when compared to the control group.

At its heart, this experiment was an evaluation of two
different teaching models.3 Investigators compared the Direct
Instruction Model — a traditional teaching model where teachers directly teach
students and reward them for correct answers — to the High/Scope model where
teachers set up the daily routine but allow children to plan, do, and review
their own activities. Thus students engaged
in active learning — individually, in small groups, and as whole-class groups.
This model of instruction ties in directly with the HOM. It allows learners to
use each of the 16 HOM in their daily learning and demonstrates that this
teaching model can improve educational performance at a young age and has
long-term impact in terms of success in the learner’s personal life.

Additionally, Tough attributed the difference between the
two groups to the development of “noncognitive skills” in the Perry Preschool
group. These skills were a sum of behaviors that were observed and recorded over
the decades among the two groups. The schools tracked “personal behavior” which
included how often the students swore, lied, stole, or were absent or late to
school. They also recorded behaviors of “social development” which tracked
characteristics such as curiosity and peer relationships. Students in the intervention group performed
much better. Thus the High/Scope teaching
model likely facilitated the development of many of the HOM such as Managing Impulsivity, Responding with
Wonderment and Awe and Applying Past
Knowledge to New Situations.

The HOM complement the traditional and widely accepted
educational theories that explain how people learn. They rely on the same
fundamental concepts of these more traditional theories, but provide an
explanation of how intelligent people use knowledge and add an element of
accountability and responsibility. John Campbell, faculty at Central Queensland University in
Australia, describes the parallels between HOM and other learning theories,
including constructivism and social learning theory.4 He explains
that in order to construct knowledge, learners must reflect, plan and evaluate
(i.e. Metacognition) as well as use
senses to gather data from their surroundings (i.e. Gathering Data through all Senses). Additionally, he explains that
constructivism emphasizes the use of group interaction (i.e. Thinking Interdependently) and active
rather than passive learning (i.e. Questioning
and Posing Problems, Managing
Impulsivity). Campbell compares the
three aspects of social learning (observation, language and self-talk) with HOM,
explaining that “self-talk” corresponds with Managing Impulsivity and Metacognition,
“language” relates to Thinking and
Communicating with Clarity and Precision and “observation” is demonstrated by Gathering Data through all Senses.

While still a relatively new concept, I believe the HOM have the
potential to significantly influence the way we educate children and adults. By
incorporating the HOM into learning exercises, educators can enhance what is
learned and improve its application to other situations in life. After all, the
purpose of education is to provide a structured environment where learners
develop in all domains of their lives:
academically, personally, and professionally.

February 21, 2013

by Lizhi Liang, Ph.D., Doctor of Pharmacy Candidate,
University of Maryland School of Pharmacy

If you were to ask “Do you
think you are a creative person?”, how often would you expect people to answer
“Yes, I am.” Not many. What differentiates a creative person from a
non-creative person? Were we born with
creativity but somehow lost it as we grew older? If so, whom should we blame?
Can we save or restore our creativity? We will be educating future generations,
thus it is important for us to answer these questions and try to find
solutions.

Creative
individuals usually have unique characteristics such as independence,
innovation, curiosity, confidence, and risk-taking behaviors.1 These are similar characteristics we often
find among children. Try to imagine how many times you are amazed by the
imagination of a child asking you questions that makes you think. Picasso once said: “all kids are born to be
artists”.2 We were all born
with curiosity, creativity, and originality.
What happened during our maturation process that made many of us lose
these traits? Sir Kenneth Robinson once told a story
about a little girl who seldom concentrated on anything, but one day she
sat for a long period time drawing a picture of God. The teacher asked her “what are you drawing”?
She responded “I am drawing God.” “But
nobody knows what God looks like” replied the teacher. And the girl answered confidently “they will
in a minute.”2 What a smart and creative girl! This is not rare among
kids. If you observe carefully, you will be surprised to see how creative these
small creatures are. Why does this kind of creativity disappears as they grow
up. Is our educational system limiting
or inhibiting creativity? Do teachers encourage or discourage creativity? Do
teachers stifle curiosity of students by telling them to follow orders and
adhere to norms? Do teachers teach subject matter based on what’s known rather
exploring what’s unknown? Do teachers coercively influence students’ decision making?
If you answered yes to any of these questions, then improvement is needed to
preserve creativity among learners.

Here are a few things educators can do to foster creativity:1. Allow time for creative
thinking3

Teachers
should try to avoid bombarding students with extraneous material. This will
only encourage memorization and regurgitation. Good educators teach students
the tools they need to solve problems. Like an old saying in China states: “It is much
better to teach a hungry person how to fish than give him fish to eat.” An
individual needs to be innovative in order to thrive on his/her own. Being able
to think independently is an indispensable part of being creative and teachers
can help students to cultivate their creative, independent thinking skills. If
every teacher designed individual problems for students to solve problems on
their own, it will convey the signal to students that thinking is a necessary ingredient
of learning. And sooner or later, students will form a habit of thinking independently
as a result of repetitive practice.2.Be creative yourself3,4

Some
educators are resistant to change. They can teach the same material, use the
same strategies, and ask the same questions throughout their entire teaching
career. In order to cultivate creativity
in their students, teachers have to be creative themselves. For example, a
teacher shouldn’t always provide detailed protocols in the lab and ask the
students to follow each step. And teachers shouldn’t expect each student to
come up with the same result. Ask
students to write their own protocol, design their own experiment, and analyze
their own data. When the experimental results are not optimal, ask them to
troubleshoot on their own and provide only the amount of guidance that is
necessary. This way, not only will students feel more excited and challenged,
but this will also promote self-discovery.3.Reward creative ideas or products3,5

Educators
need to create an encouraging atmosphere in the class to promote student
creativity. They need to let students know that creative ideas and products are
welcomed. Otherwise, students may not be willing to share due to a lack of
confidence and recognition. Rewards and encouragement are very important for
learning, especially children. In students’ eyes, teachers are the authority
and role models, so any words of encouragement from the teacher means a lot to
them. One of my friends told me a story that affected him enormously. When he
was little, he loved to read and always came up with “strange” ideas or
questions. One day when he asked a question in class, his teacher humiliated
him in front of the whole class by saying “you think you are smart by asking
strange questions?” Those words hurt his self-confidence and he felt defeated
for a long period of time. He lost
motivation to learn and became a very quiet student. Fortunately, as he grew
up, he realized that it was not his fault, but rather an irresponsible teacher
who did not appreciate his creativity. Later, he re-gained his confidence and
became a very successful researcher. This example demonstrates how educators
are powerful influences on students. Creativity
can only be cultivated in a proper environment.References

The United States is
notorious for its diversity. Over the past several decades the use of a language
other than English at home has increased by 148 percent.1 The number of non-English speakers increased
from 23.1 million in the 1980’s to 57.1 million in 2009. This rapid change can be seen throughout the
country, whether it’s a Chinese language television station or a road sign in Spanish,
the linguistic diversity continues to evolve.

Language barriers are
becoming progressively more challenging for the delivery of health care
services. Given the heterogeneity of ethnic origins and the primary languages
among these groups, individuals who have limited English proficiency have significant
challenges when communicating with health care providers. Patients with poor
communication skills have difficulty accessing care and conveying their
health concerns to practitioners. In
many health care settings, there is a lack of interpreters. This often results in
misdiagnosis, inappropriate treatments, and the delivery of suboptimal care.2 Moreover, patients with limited English proficiency
report being less satisfied, less likely to understand medication instructions,
and more likely to have problems adhering to their medication regimens.

But why should this be? It
shouldn’t. We invest billions of dollars in systems and programs for providing
medical care and finding cures for diseases.
Why can’t we invest resources in systems and programs for patients with
language barriers?

As pharmacists, we are
responsible for providing excellent care in order to achieve optimal outcomes
for our patients and enhance their quality of care. It is our mission to provide our patients with
a level of comfort and an opportunity to be understood. And we should communicate clearly with our
patients so that we can arrive at the best decisions together. Being a pharmacist isn’t about filling
prescriptions for our patients, but creating a bond that enables us to ensure a
positive outcome, regardless of any barriers. Whether the patient is in a
hospital, outpatient clinic, or a community pharmacy, this process requires
excellent communication between the patient and the pharmacist to ensure the
quality and safety of drug therapy.3 Patients who don’t fully understand their
treatments are less likely to follow-up, which in turn puts them at greater risk
of being hospitalized or experiencing drug complications. For example, patients with asthma are at
greater risk of intubation if they fail to properly use their treatments.4

Using visual methods can help.
Going to the drawing board, showing pictures, and drawing examples can paint a
clearer picture for our patients. If
nothing else, it demonstrates the effort put forth to help them. Using plain
language and avoiding technical jargon is a strategy for making written and oral
information easier to understand. Written materials can be referred to at a later
time. Printed instructions for patients
that contain pictographs and photographs that demonstrate medication-use
techniques can be very useful in this patient population.2 However, a
better long-term solution to this problem is for our healthcare system to
invest in a powerful interpreter service that is consistently available in order to facilitate
optimal communication between providers and patients. This will, in turn, improve
patient satisfaction and safety.5,6

Despite ongoing efforts to
increase awareness of communication difficulties in patients with limited
English proficiency, health disparities continue to exist. Our challenge as pharmacists involved in the
direct care of patients is not only to provide medications, but create a
welcoming environment that encourages them to seek care even when language
barriers exist. Our job is to build a
system that can mitigate communicate problems and deliver the best possible
care to diverse patient populations.

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